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. 2020 May 29;10(6):354.
doi: 10.3390/diagnostics10060354.

MRI Types of Cerebral Small Vessel Disease and Circulating Markers of Vascular Wall Damage

Larisa A Dobrynina  1 , Maryam R Zabitova  1 , Alla A Shabalina  1 , Elena I Kremneva  1 , Bulat M Akhmetzyanov  2 , Zukhra Sh Gadzhieva  1 , Alexander B Berdalin  3 , Ludmila A Kalashnikova  1 , Elena V Gnedovskaya  1 , Marina V Krotenkova  1
Affiliations

MRI Types of Cerebral Small Vessel Disease and Circulating Markers of Vascular Wall Damage

Larisa A Dobrynina et al. Diagnostics (Basel). .

Abstract

The evaluation of the clustering of magnetic resonance imaging (MRI) signs into MRI types and their relationship with circulating markers of vascular wall damage were performed in 96 patients with cerebral small vessel disease (cSVD) (31 men and 65 women; mean age, 60.91 ± 6.57 years). The serum concentrations of the tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor-A (VEGF-A), and hypoxia-inducible factor 1-α (HIF-1α) were investigated in 70 patients with Fazekas stages 2 and 3 of white matter hyperintensities (WMH) and 21 age- and sex-matched volunteers with normal brain MRI using ELISA. The cluster analysis excluded two patients from the further analysis due to restrictions in their scanning protocol. MRI signs of 94 patients were distributed into two clusters. In the first group there were 18 patients with Fazekas 3 stage WMH. The second group consisted of 76 patients with WMH of different stages. The uneven distribution of patients between clusters limited the subsequent steps of statistical analysis; therefore, a cluster comparison was performed in patients with Fazekas stage 3 WMH, designated as MRI type 1 and type 2 of Fazekas 3 stage. There were no differences in age, sex, degree of hypertension, or other risk factors. MRI type 1 had significantly more widespread WMH, lacunes in many areas, microbleeds, atrophy, severe cognitive and gait impairments, and was associated with downregulation of VEGF-A compared with MRI type 2. MRI type 2 had more severe deep WMH, lacunes in the white matter, no microbleeds or atrophy, and less severe clinical manifestations and was associated with upregulation of TNF-α compared with MRI type 1. The established differences reflect the pathogenetic heterogeneity of cSVD and explain the variations in the clinical manifestations observed in Fazekas stage 3 of this disease.

Keywords: MRI-types; cerebral small vessel disease; cognitive dysfunction; neuroimaging; tumor necrosis factor-alpha; vascular endothelial growth factor A; white matter hyperintensities.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Dendrogram showing the hierarchical classification of patients. The x-axis represents the grouped objects; the y-axis is the cluster proximity.
Figure 2
Figure 2
Characteristic changes observed in MRI types 1 and 2 of Fazekas stage 3 cerebral small vessel disease (cSVD) on FLAIR (highlighted with a white square) and axial susceptibility weighted imaging sequence (SWI) MRI slices.
Figure 3
Figure 3
Comparative analysis of vascular endothelial growth factor-A (VEGF-A) and tumor necrosis factor-α (TNF-α) levels between patients with MRI type 1 and MRI type 2 and the controls.
See this image and copyright information in PMC

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